Pain is an essential symptom of cancer. At the final stages of the disease from tolerable, it gradually turns into a strong, painful and constant. With the appearance of foci of metastasis, depending on the localization of these processes, the pain can acquire not only a somatic character, neuropathic pain joins it. The most common causes of pain: 1) tumor infiltration or compression of various structures or frolic complication (e.g. pathological vertebral fracture due to metastatic lesion); 2) cancer cachexia (a common cause of fascial muscle pain); 3) specialized treatment (eg, plexopathy due to radiotherapy, pain after mastectomy, neuropathy due to chemotherapy); 4) other concomitant diseases (e.g., headache, coronary pain). Patients with such complaints are 90% of patients in our palliative care center. We have developed certain algorithms for working with such patients, taking into account the specifics of cancer patients who are in the last stages of the disease.